Trimetazidine Limits the Effects of Myocardial Ischaemia During Percutaneous Coronary Angioplasty

Abstract

SummaryThis open-label, randomised, controlled study is aimed at assessing the effect of pre-treatment with the metabolic agent trimetazidine on the degree of ischaemia during percutaneous transluminal coronary angioplasty (PTCA).Overall 44 patients with one-vessel coronary artery stenosis (>70%) in the medial part of the left anterior descending artery were included. One group (n = 22) was pre-treated with oral trimetazidine. The other group (n = 22) was the control. All patients (n = 44) were administered aspirin and conventional treatment.All patients underwent PTCA; stents were implanted in 11 trimetazidine patients and in seven control patients.The mean ST-segment elevation during all balloon inflations was significantly lower in the trimetazidine group than in the control group (−1.66 ± 1.50 mm vs. 3.29 ± 1.59 mm, p = 0.001). Maximal ST-segment elevations andmean ST elevation values during sequential balloon inflations were also significantly lower with trimetazidine (p = 0.018). The mean amplitude of the T-wave alterations during all balloon inflations was significantly lower with trimetazidine (3.09 ± 2.39 mm vs. 6.83 ± 4.31 mm; p = 0.001). Similarly, the maximal amplitude of the T-wave alterations was 4.50 ± 2.90 mm with trimetazidine vs. 9.25 ± 4.97 mm in control patients (p = 0.0005). Angina and rhythm disturbances were more frequent in the control group. Time from balloon inflation to onset of angina was 50 ± 26.2s with trimetazidine vs. 32 ± 15.0s, for control group (p = 0.03). The time to pain relief after deflation was 19.3 ± 11.4s with trimetazidine vs. 28.2 ± 16.8s (p = 0.001).Trimetazidine administered a few days before PTCA appears to be a cardioprotective agent for the prevention of myocardial ischaemia.